1. Technical Field
The present disclosure is directed to an electrosurgical apparatus. More specifically, the present disclosure is directed to an electrosurgical apparatus that employs ultrasound for precise tissue sealing and blade-less cutting.
2. Background of the Related Art
Open or endoscopic electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis. The electrode of each opposing jaw member is charged to a different electric potential such that when the jaw members grasp tissue, electrical energy can be selectively transferred through the tissue. A surgeon can cauterize, coagulate/desiccate and/or simply reduce or slow bleeding, by controlling the intensity, frequency and duration of the electrosurgical energy applied between the electrodes and through the tissue.
Certain surgical procedures require more than simply cauterizing tissue and rely on the combination of clamping pressure, electrosurgical energy and gap distance to “seal” tissue, vessels and certain vascular bundles. More particularly, vessel sealing or tissue sealing utilizes a unique combination of radiofrequency (RF) energy, clamping pressure and precise control of gap distance (i.e., distance between opposing jaw members when closed about tissue) to effectively seal or fuse tissue between two opposing jaw members or sealing plates. Vessel or tissue sealing is more than “cauterization”, which involves the use of heat to destroy tissue (also called “diathermy” or “electrodiathermy”). Vessel sealing is also more than “coagulation”, which is the process of desiccating tissue wherein the tissue cells are ruptured and dried, “Vessel sealing” is defined as the process of liquefying the collagen, elastin and ground substances in the tissue so that the tissue reforms into a fused mass with significantly-reduced demarcation between the opposing tissue structures.
Many electrosurgical instruments include a cutting member for cutting sealed tissue. Existing methods involve the use mechanical or electrical cutting actions. For example, a knife may be included in an electrosurgical instrument. Alternatively, an electrode may be used to apply electrical energy in the region. The use of a knife or electrode may be disadvantageous because it may lead to uncontrollable wide thermal spread.
Ultrasound may also be used for sealing and cutting tissue. One such example is an ultrasonic scalpel that uses an acoustic transducer operating in a longitudinal mode at 55 KHz located remotely from tissue. Energy is amplified and transmitted to the blade system by an acoustic mount coupled to the housing of a hand piece. Mechanical energy propagates in a metallic rod of the blade system having jaw members at a distal end thereof. However, such a device can not concentrate ultrasound waves in a precise spot and, as a result, may have an even larger thermal spread then many radio frequency electrosurgical devices.